"In practice, here, I would say if the financial pressure leading to these decisions is coming from the financial boards or government officials, than you have identified the senior level of management responsible: Those boards or government officials. But someone, somewhere, is making a decision to sacrifice safety to meet financial targets, and I seriously doubt that decision is being made in the IT departments of hospitals."
Thing is, when the bad decision is coming from UP TOP (and when it comes to governments, a SOVEREIGN entity with no higher authority), what can you do? You're basically outranked. And given the scope of the problem, voting with your feet is simply a matter of leaping between sinking ships.
Biting the hand that feeds IT
